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Lancet. 2014 Jan 11;383(9912):156-65. doi: 10.1016/S0140-6736(13)62229-1. Epub 2014 Jan 8.

How to increase value and reduce waste when research priorities are set.

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James Lind Initiative, Oxford, UK. Electronic address:
School of Public Health and School of Medicine, Yale University, New Haven, CT, USA.
Center for Evidence-Based Medicine and Health Outcomes Research, Division of Internal Medicine, University of South Florida, Tampa, FL, USA; Department of Hematology and Department of Health Outcomes and Behavior, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Istituto di Ricovero e Cura a Carattere Scientifico Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
RAND Europe, Cambridge, UK.
UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), WHO, Geneva, Switzerland.
Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia.
Stanford Prevention Research Center, Department of Medicine, School of Medicine, Stanford University, Stanford, CA, USA; Division of Epidemiology, Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, CA, USA; Department of Statistics, School of Humanities and Sciences, Stanford University, Stanford, CA, USA; Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA.
Institute of Education, London, UK.


The increase in annual global investment in biomedical research--reaching US$240 billion in 2010--has resulted in important health dividends for patients and the public. However, much research does not lead to worthwhile achievements, partly because some studies are done to improve understanding of basic mechanisms that might not have relevance for human health. Additionally, good research ideas often do not yield the anticipated results. As long as the way in which these ideas are prioritised for research is transparent and warranted, these disappointments should not be deemed wasteful; they are simply an inevitable feature of the way science works. However, some sources of waste cannot be justified. In this report, we discuss how avoidable waste can be considered when research priorities are set. We have four recommendations. First, ways to improve the yield from basic research should be investigated. Second, the transparency of processes by which funders prioritise important uncertainties should be increased, making clear how they take account of the needs of potential users of research. Third, investment in additional research should always be preceded by systematic assessment of existing evidence. Fourth, sources of information about research that is in progress should be strengthened and developed and used by researchers. Research funders have primary responsibility for reductions in waste resulting from decisions about what research to do.

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